Nearly 111,000 People in Estonia Left Without a Permanent Family Doctor
Estonia's National Audit Office reports a growing number of residents without a permanent family doctor, with more physicians retiring in coming years than residency programmes will train. Experts and the minister disagree on solutions.
In Estonia, a Baltic state, about 110,700 people have no permanent family doctor, according to a new report by the National Audit Office (the state auditing body), cited by the news portal ERR.ee. Four years ago the figure was around 72,500. More than half of family doctors who run their own patient lists are over 60, and significantly more are due to retire in the coming years than the residency programme will train.
Pressure on the health system
The audit points to broader problems. Health Insurance Fund spending on specialised care in 2025 was roughly 70% higher than in pre-pandemic 2019, yet the number of outpatient appointments fell by 8%. In March 2026, more than 10,500 bookings for first appointments with narrow-field specialists involved a wait of over 60 days. Emergency departments received more than 452,000 visits in 2025, and 58% were in the green triage category; the Audit Office says some of these problems could have been handled outside emergency departments if accessible care were available.
Differing views on solutions
Elle-Mall Sadrak, head of the Estonian Society of Family Doctors, argues the issue is less an overall shortage than uneven distribution across regions: about 900 people hold family doctor qualifications, while there are roughly 780 patient lists. She points to a bill on risk zones and crisis regions that would allow more flexible work arrangements, such as part-time remote consultations. She also calls for a mechanism to protect doctors from violent or abusive patients.
Social Affairs Minister Karmen Joller, herself a family doctor (Reform Party), links the shortage to the state expanding training too slowly in earlier years. A record 46 people were admitted to family medicine residency this year, but training takes four years. She considers the current model the most suitable and proposes gradual improvement: higher pay for doctors treating complex patients and digital tools, including a project launched in November in which artificial intelligence helps doctors prepare medical documentation faster.
Katrin Rehemaa, head of the Estonian Medical Association, notes that not all residency graduates take their own patient lists, and some choose private practice. In her view, the model created in the early 1990s needs revisiting, with some duties shifted to nurses and support staff.
The Audit Office urges the Ministry of Social Affairs to review reform priorities and align plans with real financial, staffing and technical capacity.
